Personalized Medicine and Pharmacogenomics: Revolutionizing Drug Response in Chronic Diseases

Personalized medicine represents a transformative shift in healthcare, leveraging individual genetic profiles to optimize therapeutic outcomes. Pharmacogenomics (PGx), a cornerstone of this approach, elucidates how genetic variations influence drug metabolism, efficacy, and toxicity. This comprehensive review synthesizes advances in PGx applications for chronic diseases including cardiovascular disorders, cancer, depression, and diabetes highlighting clinical implementation frameworks, technological innovations, and persistent challenges. Evidence demonstrates that PGx-guided prescribing reduces adverse drug reactions by 30-50% and improves therapeutic efficacy in diverse populations. Key developments include clinical decision support systems integrating CPIC/DPWG guidelines, preemptive genotyping strategies, and polygenic risk scores for complex drug responses. Despite progress, significant barriers persist: limited ancestral diversity in genomic databases, ethical dilemmas surrounding incidental findings, healthcare system fragmentation, and economic constraints in low-resource settings. The evolution toward multi-omics integration and artificial intelligence promises enhanced prediction accuracy for multifactorial conditions. Realizing PGx’s full potential requires addressing implementation science gaps, fostering global collaborations to reduce disparities, and developing standardized frameworks for clinical translation. This paradigm shift toward genetically-informed prescribing will ultimately optimize drug therapy for chronic disease management.